Physical Therapy Prior to Total Knee Replacement

Effect of Physical Therapy on Grade 3 or 4 Knee Osteoarthritis

In this study, the investigators are investigating the effects of physical therapy (PT) for treating high grade knee osteoarthritis (OA) in patients that are candidates for total knee replacement. Through the examination of patient outcomes, such as pain, stiffness, and physical function, the investigators will determine if PT prior to total knee replacement is an effective treatment in a patient with high grade OA.

Inclusion Criteria:

1. Knee osteoarthritis (Kellgren-Lawrence grade 3 or 4) confirmed via standing AP radiograph
2. Surgical candidate for TKA, having had a least a 3 months of pain affecting ADL's unresponsive to conservative treatment consisting of AT LEAST one non-narcotic medication AND one injection (corticosteroid or series of viscosupplementation). Injection must not have been administered within 6 weeks of start of PT trial
3. Prior knee surgery from arthroscopies, meniscal surgery and ligament reconstruction

Exclusion Criteria:

1. Anyone who received physical therapy in the last 6 months
2. Inability to walk unaided for >1 block
3. Currently engaged in regular PT or a regular home exercise program
4. Prior knee arthroplasty
5. Prior knee surgery for trauma, tumor and osteotomy
6. Injection given within 6 weeks of starting therapy
7. Patients using daily narcotic medications within prior 6 weeks